Systemic sclerosis—or scleroderma that affects the skin and internal organs—is one of the rarest autoimmune diseases, affecting roughly 100,000 people (primarily women) in the United States. However, systemic sclerosis is devastating—it has the highest mortality rate among rheumatic diseases, according to Dinesh Khanna M.B.B.S., M.Sc., director of the Michigan Medicine Scleroderma Program.